Disseminated Actinomycosis- ...Computed tomography of the chest and abdomen revealed multiple pulmonary nodules (Panel A) associated with pericardial effusion, pleural effusions in both lungs, and multiple liver lesions. Biopsy of the lung was performed with the use of video-assisted thoracoscopic surgery. Multiple lesions containing sulfur granules characteristic of actinomycosis were observed along the bronchial vascular bundle (Panels B and C, with Panel C providing a close-up view of the circled area in Panel B; staining with hematoxylin and eosin). Filamentous bacteria were highlighted on silver staining (Panel D). The patient received a diagnosis of disseminated actinomycosis, an uncommon, slowly progressive bacterial infection caused by actinomyces species that can be manifested in the formation of multiple abscesses and sulfur granules in infected tissue... #NEJM #clinical #radiology #CT #disseminated #actinomycosis #sulfur #actinomyces